Trace impurities of Al, Ca, Co, Fe, K, Mg, Mn, Na, Ni in silicon nitride powder were determined by slurry introduction into a solution-cathode glow discharge-atomic emission spectrometer (SCGD-AES).The effect of particle size on the stability of suspension was investigated.A 6-port valve was selected to link sampling system and SCGD-AES, by which the suspension could be introduced into the SCGD-AES to get instantaneous spectrum signal.The calibration curves for quantitative analysis could be established using aqueous standards and the pH of suspension was not required to be adjusted accurately.The applied voltage, solution flow rate, and integral time of PMT were set to 1080 V, 1.2 mL/min and 800 ms, respectively.In this work, slurry sampling was combined with SCGD-AES by a 6 port 2-pos valve.Powder Si3N4 was tested by this way and the limits of detection for all nine elements were 0.2-53.0 mg/kg.The RSDs were 1.1%-5.0%.The detection result of trace impurities in standard reference material ERM-ED101 agreed with that obtained from inductively coupled plasma atomic emission spectrometry.This method was proved to be accurate, reliable and valuable.

Objective To explore the mutation of Y-STR loci in meiotic allelic transmission in a large pedigree. Methods The oral swabs of 163 male individuals were collected froma L in pedigree. Twenty-two Y-STR genetic markers were typed with AGCUY 24 fluorescent detection kit (AGCUY 24 sys-tem), which also contained 16 Y-STR markers included in Y filerTmmultiple amplification kit (Y filer system). The genotyping results of Y-STR loci were compared between each two males in the pedigree. Results There were 20 and 30 kinds of haplotypes obtained with Y filer and AGCUY 24 systems in 163 male individuals fromthe L in pedigree, respectively. The rates referred to haplotype differences (RRHD) of these two typing systems between male pairs were 0.910 5 and 0.922 7, respectively. The average number of marker differences were 6.582 1 and 9.824 8, respectively. The RRHDincreased along with the incidents of meiosis. Conclusion Y-STR mutation leads to different Y-STR haplotypes among the male members in a paternal pedigree and the rate of difference increases along with the incidents of meiosis.

Autoimmune pancreatitis (AIP) is an autoimmune-mediated abnormal chronic inflammatory disorder and is often misdiagnosed as pancreatic neoplastic lesions. With in-depth studies of this disease in recent years, it has been taken seriously by hepatobiliary physicians and surgeons. This article summarizes the clinical features, diagnostic criteria, and treatment methods for autoimmune pancreatitis at the present stage, so as to provide clinicians with diagnosis and treatment experience to reduce clinical misdiagnosis.

The incidence rate of thyroid cancer and thyroid nodule in China are rising and surgical operation is the main treatment for thyroid nodule and thyroid carcinoma.It has been controversial whether thyroid surgery is suitable for day surgery.Perfect preoperative examination and anesthesia assessment,selection of an appropriate of patients and minimally invasive surgery,good postoperative analgesia and the prevention and treatment of postoperative nausea and vomiting,recognition and treatment of postoperative complications timely,postoperative follow-up,can ensure safety of patient with thyroid ambulatory surgery,and made the same medical quality as the surgery in hospital.Under certain criteria,thyroid ambulatory surgery is safety,high efficient,economy and time-efficient.It is a reasonable surgical management mode which can reduce days of hospitalization and hospitalization cost.But it still need further study on the inclusion and exclusion criteria of patients,anesthesia techniques and perioperative management.

Osteosarcoma is a highly malignant bone tumor that predominantly affects children and adolescents. Standard chemotherapy currently used is usually poor, with a lower survival rate of patients with recurrence or metastasis. And it is necessary to find precise targeted therapy drugs from a genic perspective. This paper reviews the progress of genome research on germline mutation and somatic mutation of osteosarcoma in recent years, summarizes mutations and pathways that are closely related to osteosarcoma and can reflect the characteristics of osteosarcoma in order to provide a hope for the next generation of molecular targeted therapy.

Objective:To study the changes of plasma receptor interacting protein 3 (RIP3) levels in neonatal late-onset sepsis (LOS) and to determine its clinical value.Methods:From October 2019 to April 2021, plasma samples and clinical data of LOS infants admitted to our hospital were prospectively studied. Infants with similar gestational ages admitted for non-infectious diseases were assigned into the control group. Enzyme-linked immunoassay was used to determine plasma RIP3 levels. The clinical value of plasma RIP3 in the diagnosis and treatment of neonatal LOS were analyzed.Results:A total of 152 cases (76 in the LOS group and 76 in the control group) were included in the study. No significant differences existed in the baseline data between the two groups. A total of 226 plasma samples were collected (76 samples from the LOS group before treatment, 74 samples after treatment and 76 samples from the control group). The plasma RIP3 level of LOS group before treatment (19.9±6.3 ng/ml) was significantly higher than the control group (11.4±3.5 ng/ml) and the after treatment group (11.9±3.5 ng/ml) ( P<0.05). The plasma RIP3 level had good diagnostic value for neonatal LOS (AUC=0.884). With cut-off value of 15.5 ng/ml, the plasma RIP3 showed the best diagnostic efficacy (Youden index 0.658, sensitivity 72.4%, specificity 93.4%, positive likelihood ratio 11.0, negative likelihood ratio 0.3). Conclusions:Plasma RIP3 level is closely related with neonatal LOS and may be used for the early diagnosis and therapeutic evaluation of neonatal LOS.

Objective:To explore the medication law of gilles de la Tourette syndrome (TS) in ancient TCM books through data mining.Methods:TS related disease information was searched by searching Chinese Medicine Collection Database 4.0 and Chinese Medical Classics 5.0 about liver wind, convulsion, infantile convulsion, slow infantile convulsion, Chi Zong, Jin Ti Rou Yu, chronic spleen wind. Excel 2022 software was used to input the main symptoms, etiology and pathogenesis, treatment methods and prescriptions of each disease, and the frequency, property and taste, meridian tropism and efficacy of medication were analyzed. Gephi 0.9.2 software was used to analyze the complex network of Chinese materia medica data to find out the core drugs. SPSS Statistic 25.0 software was used for clustering analysis of high-frequency Chinese materia medica (top 50 in frequency ). SPSS Modeler 14.2 software was used to analyze the association rules of high-frequency Chinese materia medica based on Apriori algorithm. Results:Totally 692 ancient prescriptions were included, involving 436 kinds of Chinese materia medica. The top five in terms of frequency were: Scorpio, Cinnabaris, Moschus, Typhonii Rhizoma, Gastrodiae Rhizoma appeared the most frequently. The main property was cold, the main taste was pungent, and mainly into the liver, spleen, and heart meridians; the core drugs were Bombyx Batryticatus, Pinelliae Rhizoma, and Glycyrrhizae Radix et Rhizoma. Clustering analysis could be divided into 8 categories. Correlation analysis showed that Scorpio→Bombyx mori Linnaeus and Cinnabaris had the highest support, while Cinnabaris→Bovis Calculus→Moschus→Scorpio had the highest confidence.Conclusions:Ancient doctors believed that the disease location of TS-related diseases are mainly liver, heart, spleen and kidney, and the pathogenic factors were mainly wind, fire, phlegm, blood stasis and deficiency. The insect snakes used in prescription drugs are used to search for wind and eliminate pathogenic factors, the epigraphy is used to calm the nerves and calm the wind, and the herbs are used to soothe the wind, clear heat, calm the liver and dispel phlegm.

Objective:To summarize the clinical characteristics of neonatal late-onset sepsis (LOS) caused by Leclercia adecarboxylata, and provide evidence for its diagnosis and treatment. Methods:We report a case of Leclercia adecarboxylata induced LOS in a male preterm neonate diagnosed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) at the Affiliated Suzhou Hospital of Nanjing Medical University. Relavant literature was retrieved from Wanfang, VIP, CNKI, and PubMed databases up to April 2021, using terms including "neonate" "sepsis" and " Leclercia adecarboxylata". Results:The patient presented with dyspnea immediately after birth with gestational age of 34 +3 weeks and birth weight of 2 050 g. After admission at 14 min after birth, he was incubated at temperature of 33-35 ℃ and humidity of 50%-60% and received active treatment, consisting of nasal continuous positive airway pressure, tracheal intubation, intratracheal injection of pulmonary surfactant, invasive mechanical ventilation, and anti-infective treatment with piperacillin, cefoperazone/sulbactam, and meropenem. However, the patient developed LOS on day 11 of life and eventually died of disseminated intravascular coagulation and multiple organs failure despite volume expansion, anti-infective therapy, and respiratory support. The blood culture was positive for Gram-negative rod and confirmed as a multi-drug resistant strain of Leclercia adecarboxylata. Two cases of LOS caused by sensitive strain of Leclercia adecarboxylata in premature female infants were retrieved in the literature with atypical symptoms, of whom one was successfully treated and one died after active treatment. Conclusions:Leclercia adecarboxylata infection alone can lead to LOS in preterm infants without typical manifestations. MALDI-TOF MS is helpful for the diagnosis and rational application of antibiotics.

Objective:To establish an indicator system for surveillance of data sources to provide a theoretical basis for respiratory infectious disease surveillance and early warning.Methods:Indicators for data sources in the surveillance of acute respiratory infectious diseases were initially compiled through a literature search. Subsequently, two rounds of expert consultations were conducted with 22 experts using the Delphi method to refine the indicators.Results:The questionnaire recovery rates for the two rounds of expert consultation were 100.00% and 86.36%, respectively. The authority coefficient of the experts was 0.83. The coordination coefficient of the second round of Delphi expert consultation was 0.32, and the coefficient of variation of each indicator was less than 0.25. Finally, the indicators system of data source for the surveillance of acute respiratory infectious diseases includes 4 first-level indicators, 10 second-level indicators, and 26 third-level indicators.Conclusion:The indicator system of data sources for the surveillance of acute respiratory infectious diseases constructed in this study is reasonable and reliable, providing a valuable reference for surveillance, early warning and policy formulation of acute respiratory infectious diseases.

Objective:To evaluate the predictive effect of the loss of signal (LOS) on the recurrent laryngeal nerve (RLN) injury.Methods:The literatures on PubMed, Web of Science, CNKI, and Wanfang Medical Network database were published before 30 April 2023. English search terms included "thyroid gland surgery" "thyroidectomy" "intraoperative neuromonitoring" "intraoperative nerve monitoring" and "recurrent laryngeal nerve". Chinese search terms included "thyroidectomy", "thyroid surgery" "recurrent laryngeal nerve" "intraoperative nerve monitoring". Two evaluators screened the literature, extracted the materials and evaluated the risk of bias of the study independently. If there were different opinions, researchers should resolve which through consultation and ask the third-party researcher when necessary. The Meta-analysis was performed with the Review Manager 5.4 software.Results:A total of thirty-three studies were included and were all analyzed for primary outcome measures while only twenty-six of which were analyzed for secondary outcome measures. Meta-analysis showed that the positive predictive value of LOS in intraoperative nerve monitoring (IONM) was 65% [ OR=1.88, 95% CI: 1.36-2.60]. Then these thirty-three articles included in IONM were divided into I-IONM, C-IONM and mixed groups. Subgroup analysis showed that the positive predictive value of LOS in I-IONM, C-IONM and mixed groups were 62% [ OR=1.63, 95% CI: 1.05-2.52], 75% [ OR=2.93, 95% CI: 1.64-5.22] and 70% [ OR=2.38, 95% CI: 1.77-3.12] respectively. When these thirty-three included articles were divided into Asian, European, North American and Oceania, subgroup analysis showed that the positive predictive value of LOS was 50% [ OR=1.01, 95% CI: 0.44-2.31], 70% [ OR=2.29, 95% CI: 1.60-3.28], 82% [ OR=4.68, 95% CI: 3.79-5.78] and 83% [ OR=4.81, 95% CI: 3.10-7.46] respectively. Meta-analysis of secondary outcome measures in twenty-six articles showed that the negative predictive value of LOS was 99.6% [ RD=1.51, 95% CI: 1.48-1.53], with the sensitivity of 89% [ RD=1.24, 95% CI: 1.11-1.37] and specificity of 98%[ RD=1.43, 95% CI: 1.40-1.47]. Conclusion:The occurrence of LOS during IONM in thyroidectomy has a positive prediction effect and a higher negative prediction effect, sensitivity and specificity on RLN injury.